Vesical clear cell adenocarcinoma is an uncommon tumour. The description of nearly all published cases focuses on histological issues, providing few clinical particulars and limited followup. The treatment choice is resection. No publications have been found regarding systemic treatments for advanced disease. We present a case of metastatic clear cell adenocarcinoma of the bladder treated with chemotherapy.
Background: Small cell lung cancer (SCLC) is the most aggressive histologic type of lung cancer. It consists in approximately 10-15% of all lung cancer cases. There are very few studies on its risk factors besides tobacco, and even less have analyzed the effect of residential radon. We aim to know the risk factors of SCLC. Method: We designed a multicenter, hospital-based case-control study with the participation of 11 hospitals in 4 regions of Spain. An interview about personal, family and work history, as well as tobacco and alcohol consumption and diet habits, was made to each case. Also the cases were provided with a radon detector, and a genetic blood test was made. Result: Results of the first 113 included cases, 63 of them with residential radon measurements, were analyzed. Median age at diagnosis was 63 years old and 11% of cases were younger than 50. 22% of cases were women. 57% had extended disease and 95% were smokers or ex-smokers. Median residential radon concentration was 128 Bq/m3. 8% of cases had concentrations higher than 400 Bq/m3. The only remarkable difference by gender was the percentage of never smokers, which was higher in women compared to men (p<0,001). Radon concentration was higher for extended disease (non-significant difference) and was higher for patients diagnosed at 63 or older (p¼0,032). Conclusion: A high percentage of SCLC cases are diagnosed at an earlier age. There is a predominance of extended disease at diagnosis (57%). Age and stage at diagnosis are similar between men and women, although it appears that men tend to be diagnosed with stage IV cancers more often. Regarding the concentration of radon, it is elevated in SCLC when compared, for example, with data from the general population of Spain. It can be seen that subjects with extended cancer have a slightly higher radon concentration and that older subjects at diagnosis have significantly higher radon concentrations than younger cases.
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